Studying Milk Allergies And Constipation
Researchers at the University of Palermo in Italy worked with 65 children with chronic constipation. All of these children had been treated with laxatives when dietary measures had failed. Even with the medical treatment, these children were still constipated, having hard, painful stools only every 3 to 15 days. Forty-nine of their little bottoms had fissures and redness or swelling from the hard plugs of stool.
Each child received either cows milk or soymilk for 2 weeks, with no one knowing which was which. Next, they had a week during which they could eat and drink anything they wanted to wash out the effects of the first 2 weeks. Then they switched sides for 2 weeks and got the milk that they didnt get the first time. Careful recordings of the bowel habits were made.
When the secret code was broken at the end of the study, they found status quo constipation for each child while he or she was on cows milk. But while they were taking soymilk , 68% of these kids were no longer constipated! The redness, swelling, and fissures on their bottoms healed. How wonderful to finally have relief after diet and medicines hadnt worked for so long!
The results were most dramatic in kids who also had frequent runny noses, eczema, or wheezing. Nevertheless, sometimes constipation can be the only symptom of cows milk intolerance.
Chronic Constipation: A Result Of Cows Milk Intolerance
AAP Grand Rounds
Chronic Constipation: A Result of Cows Milk Intolerance. AAP Grand Rounds January 1999 1 : 3.
Iacono G, Cavataio F, Montalto G, et al. Intolerance of cows milk and chronic constipation in children. 1104.
Chronic diarrhea is the most common gastrointestinal symptom of intolerance to cows milk in children. The study by Iacono et al hypothesized that intolerance to cows milk may also cause chronic constipation in children secondary to perianal lesions and pain upon defecation causing retention of feces. The study examined 65 children in a double-blind, cross-over analysis comparing soy milk to cows milk in infants and children ages 11 to 72 months who had been referred to a pediatric GI clinic because of chronic constipation defined as chronic fecal retention , often associated with abdominal symptoms. All patients had previously been treated with laxatives with no response.
Regardless of the antibody involved, Iacono et al offer us an alternative therapy that is worth trying when confronted with an infant or toddler with chronic constipation. The change to soy is a benign therapy with minimal, if any, risk. Most importantly, it may allow…
Constipation As A Symptom Of Cows Milk Protein Allergy
Chronic constipation in infants has been shown to be related to the ingestion of cows milk and a symptom of CMPA.7,8 In some cases, the frequency of CMPA can be as high as 80% in constipated infants.7
The majority of infants affected with CMPA have at least two symptoms affecting at least two different organ systems.9,10 If, in addition to constipation, your patient shows any of the signs and symptoms that can be related to CMPA11 , you can use the CoMiSS® tool12 to score the combination of their symptoms and assess the likelihood of CMPA.
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How Do I Introduce Whole Milk
Some children have no issue taking whole milk right away. Other children require more of a weaning process. Weaning is simple in principle , and just involves adding in some breastmilk or formula to whole milk until your child is used to the difference in taste. There is no exact percentile, however, the goal is to add less formula or breastmilk into the mixture over time. Whole milk can be warmed if you think this will help your child transition to enjoying whole milk.
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Diagnosis Of Lactose Malabsorption And Intolerance
There are a few tests available to diagnose lactose intolerance, including hydrogen breath test, quick lactase test, lactose tolerance test, and genetic test. Naturally, along with laboratory diagnostics, attention should be paid to a properly taken history and any abnormalities in physical examination.
How Does Cows Milk Allergy Impact Infants
The symptoms of cows milk allergy are wide-ranging and non-specific meaning they are also found in many other conditions. Typically, symptoms affect the digestive and respiratory systems and the skin2-5. Many parents wait months for their baby to be diagnosed with cows milk allergy 1. The process can involve many doctor visits and can be distressing for both the parents and the child1.
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Why Is Dairy Linked To Constipation
Dairy, in general, is thought to be one of the leading causes of constipation. This could be due to how heavily processed most milk options in the market are.
The milk from cows may be contaminated by the originating cows hormones and antibiotics throughout the process. This is why their milk gets pasteurized first to eliminate its inherent bacteria. But during the process, beneficial enzymes hasten digestion, along with some critical minerals and vitamins.
Due to the high demand for cows milk, farming techniques have changed. Instead of naturally feeding cows with grass, like how they used to, now they are fed grain. So, does milk cause constipation? This farming practice poses the risk of causing digestive issues, including constipation, especially in people who are sensitive to grains.
Many health practitioners may warn patients suffering from hay fever or colds to stay away from dairy products because of their mucus-inducing properties. Drinking milk only worsens ones runny nose and causes the internal systems to slow down. This could be another potential explanation to support the affirmative answer to the question, does milk cause constipation?
Dairy products, including ice cream, cheese, and milk have long been listed as foods that lead to constipation when consumed in excess. This is likely because these dairy products are low in fiber but rich in fat.
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Methanea Connection Between Lactose Intolerance And Constipation
The major cause of symptoms, especially flatus, in food intolerance, is connected with the production of gases and toxins by gut bacteria. Owing to the low oxygen concentration in the large intestine, > 90% of the gut bacteria are anaerobes . Among numerous species residing in the gastrointestinal tract, there are also archaebacteria, responsible for methane production. Several archaebacteria phylotypes of human gastrointestinal tract were identified, including Methaninobrevibacter smithii and Methanospaera stadmagnae, methanogens in the intestine, and the Methannobrevibacter oralis archaeon in the oral cavity .
In the low-oxygenated environment, lactose becomes a source of hydrogen , methane , and hydrogen sulfide . The H2 produced can act as the substrate for the reaction carried out by methanogenic archaebacteria :
The association of breath methane level with the severity of constipation has also been investigated. Recent studies showed that constipation and bloating severity did not correlate with methane levels on a glucose breath test. However, baseline methane levels had stronger correlations with constipation compared with maximum levels of methane achieved .
On the other hand, the presence of methanogenic gut bacteria can be beneficial, especially for individuals with malnutrition. It was proved that by removing fermentative hydrogen by methanogens, the more complete oxidation of substrates is possible, which results in improving energy harvest .
Lactose And Its Derivatives
Lactose is a disaccharide, a principal carbohydrate found in the milk of most mammals. Human milk, the leading constituent of the diet of infants for the first few months of life, contains 6.7 wt% of lactose and is the main source of calories in milk . The molecule comprises D-glucose and D-galactose bonded with a -1,4-glycosidic bond .
Lactose, produced from cheese or casein whey, is a common component of infant formula, various dairy products, and pharmaceuticals . Lactoses synthetic derivative, lactulose, is used in the treatment of functional constipation as a second-line drug due to its osmotic properties. It was also discovered that lactulose plays an important role in infant nutrition as a Bifidus Factor that especially enhances the growth of Bifidobacterium in the intestinal tract .
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Dairy Is A Common Cause Of Constipation
A Double-Blind Cross Over Trial was done with 65 children struggling with Chronic Constipation to see if Cows Milk Protein was causing their constipation. Half of the children were given cows milk for the first two weeks and the other half were given soy milk for the first two weeks without being told which one they were getting. They all then had two weeks of being soy milk and cows milk free, followed by two weeks where the children who were originally given cows milk were switched to soy and the children who were given soy were switched to cows milk. Constipation resolved for 68% of the children drinking soy milk, but none of the children drinking cows milk.
How To Score This Symptom With The Comiss Tool
· The CoMiSS® tool uses the well-established Bristol stool scale13 to evaluate stool consistency
· Constipation should only be scored if it lasts for at least one week
· In addition to the stool score, if any of the following signs or symptoms related to CMPA are also present, they should also be given a score using the CoMiSS® tool. These include crying, regurgitation, skin and respiratory symptoms
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Why Does Dairy Cause Constipation
The milk that most of us buy is deemed to be a processed food due to the processes it goes through before it reaches the shelves. It may contain both antibiotics and hormones from the cows it originates from, and is almost always pasteurised in order to kill off milk-borne bacteria. Head over to the Probiotics Learning Lab to read this article about taking probiotics with antibiotics.
However, the pasteurisation process also removes valuable enzymes that help us to digest the milk, as well as other important vitamins and minerals. Additionally, in contrast to traditional farming methods, intensive farming techniques have led to cows being fed grain rather than grass. This has the potential to cause further digestive problems and act as a trigger for constipation, particularly in those sensitive to grains.
Dairy is considered by many health practitioners to be mucus-forming in the body, and for this reason it can be helpful to avoid dairy products if you are suffering from a cold or hay fever and trying to relieve a runny nose. In Traditional Chinese Medicine, milk and other dairy products are labelled as damp-inducing foods , which may also go some way to explaining why they could cause constipation and digestive problems. According to Traditional Chinese Medicine, the Spleen meridian does not like cold or so-called damp foods, with ice cream being a strong example.
Go Easy On The Coffee
While coffee can stimulate the digestive muscles that cause you to pass stool, its not a miracle cure for constipation symptoms. Thats because too much caffeine may cause dehydration, leading to a painful and hard stool. Because of this, it is best to avoid excessive amounts of food and liquids containing caffeine, including coffee, teas, soft drinks and chocolate.
According to a December 2012 review published in Nursing, its best to focus on increasing your non-caffeinated fluid intake to improve your ability to pass stool without pain. They suggest trying to drink 60 to 80 ounces of water throughout the day.
To increase your water intake, keep a bottle on your desk at work or in the car to remind you to consistently take in fluids. For the more technologically-savvy drinkers, several water drinking apps can track fluid intake and send alerts.
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Signs And Symptoms Of Lactose Intolerance
Lactose is a type of sugar found naturally in the milk of most mammals.
Lactose intolerance is a condition characterized by symptoms such as stomach pain, bloating, gas and diarrhea, which are caused by lactose malabsorption.
In humans, an enzyme known as lactase is responsible for breaking down lactose for digestion. This is particularly important in infants, who need lactase to digest breast milk.
However, as children grow older, they generally produce less and less lactase.
Some people may also develop lactose intolerance after surgery or due to gastrointestinal diseases such as viral or bacterial infections.
Here are the 5 most common signs and symptoms of lactose intolerance.
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How To Spot A Cows Milk Protein Allergy
Everyone knows that milk is a great source of nutrition for growing babies but what about when its not?
If your infant is extra fussy after eating, is having digestive issues like diarrhea or constipation, or is spitting up a lot, they may have something called a cows milk protein allergy . Although the name of this includes, “allergy,” it acts more like an intolerance and it’s important to note that this is very different from a cow’s milk allergy, which can be serious and cause anaphylaxis. As a pediatrician, I would work closely with the Children’s Wisconsin Allergy and Clinical Immunology Department for a cow’s milk allergy, but that isn’t always necessary with CMPA.
This blog is going to help explain CMPA, not a cow’s milk allergy.
If your child has CMPA, know that most babies typically outgrow it.
As a pediatrician, not only do I see patients with CMPA, but it impacted my own family. My daughter had blood in her diaper at 6 weeks old, and of course, we were alarmed. However, I had a feeling that whatever was wrong would explain her fussiness and severe spit up over the previous month. A simple test helped confirm CMPA, and after two weeks of eliminating dairy from my daughter and wife’s diet, the spit up was nearly gone and her stools were completely normal.
Starting An Elimination Diet
An elimination diet removes all potential irritants from the diet for three to five weeks and then slowly reintroduces one food at a time to help identify food sensitivities or intolerances. This time also allows your gut to heal and restores the beneficial bacterial community living in your gut. If you are confident that dairy is the food causing your discomfort and other symptoms, start by eliminating dairy and continue your normal diet. If you find that the discomfort continues, consider following a stricter elimination diet like the ones outlined in the article, Which Foods Are Causing Your Discomfort? A Test Might Not Be Able to Tell You.
During the elimination diet, you should consider recording your sleep quality, mood, energy, digestion, and bowel movements. Consider starting a food journal to capture information about your daily intake and the positive or negative symptoms that you experience.
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What Is The Treatment
Only a doctor can tell if your symptoms come from IBS or lactose intolerance. They usually diagnose IBS based on the symptoms you describe. For lactose intolerance, youâll need to give a little more information, such as:
- Your family history
- A physical exam
- A hydrogen breath test. Undigested lactose in your body gives off high levels of hydrogen. During the test, you drink a beverage that has lactose, then blow air into a special bag. A lab tests your breath to look for the gas.
IBS symptoms can come and go, but itâs a condition youâll have for the rest of your life. There is no cure for it. But you can use a few different strategies to manage how you feel. Changes to your diet and tools to handle stress may help ease your symptoms. Medications like anti-diarrhea drugs or laxatives can make you feel better, too. Itâs important to work with a doctor to find the approach that works for you.
There is also no cure for lactose intolerance, but it usually helps to avoid milk, cheese, and other dairy foods. Some people with the condition can handle small amounts of them, and others have to cut them out completely. Your doctor or dietitian can help you figure out the right diet and suggest supplements that may help. There are lactase enzyme replacements available which can be taken with food, but they have varying degrees of benefit.
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